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Please enter all your details when submitting the application form. As most correspondence is via email please let us know if you change your email address.

Title:

Surname: *

First Name(s): *

Address: *

Suburb: *

State *

Postcode: *

Phone: *

Email: *

Please tick which speciality you work in: *

HIV
Sexual Health
Sexual & Reproductive Health
Women’s Health
Men’s Health
Other

Other

Candidate Declaration - I declare I am: *

Registered Nurse
Enrolled Nurse
Midwife
Student

Place of employment or place of study: *

Position: *

I apply to become a member of the Australasian Sexual Health & HIV Nurses Association (Inc.) *

In the event of my admission as a member, I agree to be bound by the rules of the association.

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© Copyright ASHHNA 2022. PO Box 11, WODEN, ACT 2606

In the spirit of reconciliation the Australasian Sexual Health and HIV Nurses Association acknowledges the Traditional Custodians of country throughout Australia and their connections to land, sea and community. We pay our respect to their elders past and present and extend that respect to all Aboriginal and Torres Strait Islander peoples today.

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